Friendly Comprehensive
Care For Adults
Call Us Today! 970-564-8730 Fax: 888-832-1367
111 North Park Street
Cortez, CO 81321

Southwest Internal Medicine Forms

We are currently not accepting new patients. If you would like, please complete the New Patient Screening form below, return it to us and we will contact you if we have an opening, or check back here to for updates. You may return it to us by Fax – (888) 832 1367 – or drop it by our office at 111 N Park, Cortez.

Upon being accepted to the practice, please complete the New Patient Packet, and return it to us by Fax (888 832 1367) or drop it by our office at 111 N Park, Cortez.

The Records Release Form can be used to request records from our office, either to “Self” or another provider’s office.

New Patient Screening New Patient Packet Records Release

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Southwest Internal Medicine | Phone: 970-564-8730 | Fax: 888-832-1367 | info@swinternal.com |
111 North Park StreetCortez, CO 81321